In the current period (October 2023 – January 2024), nearly 459,000 children under five are facing/expected to face elevated levels of acute malnutrition.  This includes 263,000 cases in Grand Sud and 196,000 cases in Grand Sud-Est. 

During the lean period from February to April 2024 (first projection period), the most isolated districts, Nosy Varika and Ikongo are projected to move to IPC AMN Phase 4 (Critical). In the second projection period (May to September 2024), only the Betroka District of Grand Sud is projected to return to IPC AMN Phase 2 (Alert). The districts of Betioky and Ampanihy (Atsimo Andrefana), the four districts of the Androy Region, as well as Amboasary District in Anosy Region will remain in IPC AMN Phase 3 (Serious).

Determining factors of acute malnutrition are low diversity and quantity of food consumption of children, high prevalence of childhood illnesses – particularly malaria – low health services and low rates of coverage of vaccination or vitamin A supplementation.

The coordination of aid/assistance is essential to ensure that the populations of the regions of the Grand Sud and Grand Sud-Est of Madagascar receive timely and sufficient aid to face the challenges of acute malnutrition.

For Ikongo and Nosy Varika

• Immediately strengthen the coverage and quality of integrated management of acute malnutrition.
• Conduct a multi-sectoral analysis of the root causes of the continued situation of acute malnutrition in IPC Phase 3 and above throughout the year.
• Develop a multi-sectoral response strategy in these two districts.

For all districts

• Immediately strengthen the coverage and quality of integrated management of acute malnutrition.
• Continue nutritional surveillance and strengthen the early warning system, and in particular ensure regular monitoring of the nutritional situation in the face of the risk of a longer period of high malnutrition in Grand Sud (IPC Phase 3 projected as 2 in seven districts out of the 10 studied).
• Ensure protection of livelihoods/humanitarian support during peak malnutrition (quarter 1) and continue assistance to vulnerable households during the lean season (Social Protection: Money or Living).